Editorials

What evolutionary offers Randolph M Nesse a

Evolution is the foundation of biology, to avoid resistance, and the speed with sensitivity to dust mites and asthma, and biology is the foundation of medi- which resistance fades after antibiotics does that mean it is abnormal? No, it cine and public health, so you would are withdrawn remains uncertain. may well protect against schistosomiasis, think that has These advances are not well known and that protection may influence both already been applied to every possible in and public health but the prevalence of that infection and aspect of health. Remarkably, this is word is spreading. Eight major interna- asthma in certain groups.5,6 It is clear not the case.1 With the exceptions of tional conferences in the past year have that identifying genetic variations is only and methods for brought together evolutionary biolo- the first step. Explaining the variation is tracing phylogenies, other applications gists and medical researchers. In 2008, the next. New techniques for identify- are very recent developments. There are the American College of Epidemiology ing signals of selection give an increas- few evolutionary biologists in schools will devote its annual meeting to “The ingly detailed view of the evolutionary of medicine or public health, so news Dawn of Evolutionary Epidemiology”. history of deoxyribonucleic acid (DNA) about advances in this field is often The United States National Academy of sequences. The next step is harder – slow to arrive. Sciences will hold a Sackler Symposium figuring out what selection forces, if any, The publication of a new edition on and medicine in 2009. account for the presence and distribu- of Evolution in health and 2 offers There are many questions to be tion of an allele. a good opportunity to take stock. For asked about why selection has left the Establishing evolutionary biology instance, work on of pregnancy body vulnerable to disease.3 Why are as a basic science for medicine and continues to accumulate evidence that our coronary arteries so narrow and public health will take major education diabetes and of pregnancy prone to plaque? Why hasn’t natural initiatives, from undergraduate courses may be related to evolutionary con- selection found a different, safer route to scientific conferences. The Evolu- flicts between interests of the maternal for childbirth, or at least enlarged the tion and Medicine Network (available and paternal genomes and the fetus. pelvic opening? Why do we have third at: http://evolutionandmedicine.org) Imprinted genes that influence these molars, given the trouble they cause? provides information about people, conflicts have profound implications for Why can’t our bodies create better publications, courses, conferences, and in vitro fertilization policies. Life his- defences against bacteria? Why is the new opportunities in evolution and tory theory explains how selection has endothelium so vulnerable to inflam- medicine. ■ shaped rates of and its relation- mation? Such evolutionary questions ship with reproduction. The evolution- are fundamentally different from ques- References ary reasons why we remain vulnerable tions about how the body works.4 1. Nesse RM, Stearns SC, Omenn GS. Medicine to are better separated into We also have an urgent need to needs evolution. Science 2006;311:1071. aspects of modern environments, and understand the evolutionary signifi- PMID:16497889 doi:10.1126/science.1125956 tradeoffs that explain why selection can- cance of genetic variations. If a rare 2. Stearns SC, Koella JK, eds. Evolution in health and disease. 2nd edn. Oxford: Oxford University not make better protective mechanisms. allele slows ageing, can we assume it Press; 2007. The epidemic of obesity can be is superior? Not necessarily, as evo- 3. Nesse RM, Williams GC. Why we get sick: the interpreted in terms of the evolutionary lutionary patterns have shown that new science of Darwinian medicine. New York: forces that shaped dietary preferences such benefits usually have other costs. Vintage Books;1994. and appetite regulation mechanisms, If an allele accounts for much of the 4. Trevathan WR, McKenna JJ, Smith EO, eds. along with the possibility that selection vulnerability to myopia, obesity or Evolutionary medicine. 2nd edn. New York: Oxford University Press; 2008. has shaped adult physiology to cope alcoholism, does that mean it is a 5. Nesse RM. Maladaptation and . with the nutritional environment as genetic defect? No, it is more likely Q Rev Biol 2005;80:62-70. PMID:15884737 indicated by intrauterine conditions. to be a quirk, a variation harmless in doi:10.1086/431026 Antibiotic resistance, that stalwart ex- ancestral environments that results 6. Barnes KC. Genetic epidemiology of health ample of natural selection, turns out not in disease only when it interacts with disparities in and clinical . to be so simple; mathematical models aspects of the modern environment.4 J Allergy Clin Immunol 2006;117:243-54. are needed to create optimal strategies If a genotype is associated with allergic PMID:16461122 doi:10.1016/j.jaci.2005.11.030

a University of Michigan, Ann Arbor, MI 48109, United States of America. Correspondence to Randolph M Nesse (e-mail: [email protected]). doi:10.2471/BLT.07.049601

Bulletin of the World Health Organization | February 2008, 86 (2) 83